Individual
TIMOTHY MICHAEL LETHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 BONIFACE PKWY, ANCHORAGE, AK 99504-3106
(907) 337-9474
(907) 337-9476
Mailing address
2601 BONIFACE PKWY, ANCHORAGE, AK 99504-3106
(907) 337-9474
(907) 337-9476
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1133
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1622826
UCCI
AK
05
—
DD6052
—
AK
Enumeration date
08/12/2006
Last updated
07/08/2007
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